Depression Medication Use Research Articles

Comorbid Depression in Patients With Head and Neck Cancer Compared With Other Cancers

Depression is more prevalent among individuals with cancer than in the general population and is correlated with increased mortality in patients with head and neck cancer (HNC) in particular. To compare the prevalence of depression between patients with HNC and patients with other cancers. This retrospective cohort study used population-level data on patients aged 18 years or older with cancer who participated in the 2019 National Health Interview Survey and had completed the Personal Health Questionnaire-8 (PHQ-8). The analysis was performed between August 7, 2023, and April 5, 2024. Any cancer diagnosis. The main outcome was prevalence and severity of depression based on the PHQ-8. The magnitude of the difference in baseline characteristics was measured between patients with HNC and those with other cancer types, and 95% CIs were used to measure the precision of these estimates. Multivariable logistic regressions were used to evaluate the association of demographic, socioeconomic, anxiety, and clinical variables with depression. From a weighted cohort of 23 496 725 adult patients with cancer, 377 080 were diagnosed with HNC (87.5% aged 51-84 years; 77.9% male). The prevalence of any depression on the PHQ-8 (mild, moderate, or severe) was 40.1% in patients with HNC vs 22.3% in patients with other cancers. Compared with patients with other cancers, patients with HNC were equally likely to screen positive for anxiety (23.6% vs 16.0%; difference, 7.6%; 95% CI, -5.9% to 21.1%), take medication for depression (10.1% vs 13.9%; difference, -3.8%; 95% CI, -11.9% to 4.4%), and state that they never feel depressed (59.7% vs 53.7%; difference, 6.0%; 95% CI, -9.1% to 21.0%). On multivariable logistic regression analysis, having HNC was associated with an increased likelihood of depression (odds ratio [OR], 2.94; 95% CI, 1.39-6.22). Other factors associated with depression were being unmarried or not living with a partner (OR, 1.94; 95% CI, 1.55-2.43) and having anxiety (OR, 23.14; 95% CI, 17.62-30.37). This cohort study found that patients with HNC were twice as likely to screen positive for depression on a validated survey than those with other cancers, despite having similar rates of self-reported depression and depression medication use. These findings suggest that self-reporting of depression may result in underreporting and undertreatment in this population and, thus, a need for further work in developing interventions to improve identification of and optimize treatment for patients with HNC and comorbid depression.

Increased risks of Maternal Mental Health Conditions Following the COVID-19 Pandemic.

Women are at an increased risk of developing psychiatric conditions such as anxiety and depression during pregnancy. Psychiatric conditions during pregnancy can put mothers and fetuses at risk of worse physical and mental health before, during, and after the completion of a pregnancy. Previous research indicates that women pregnant during COVID-19 were at a greater risk of developing mental health conditions and being exposed to stressors. While most of the research in the field focuses solely on maternal mental health or interactions between stressors and maternal mental health, little research has been done comparing maternal mental health, demographic variables, and socioeconomic variables across pre-, during-, and post-COVID-19 time periods. We conducted an observational cohort study of 703 mothers divided into pre-, during-, and post-COVID-19 groups based on time of enrollment. Rates of maternal anxiety (p < 0.001), medication use for anxiety (p < 0.001), depression (p < 0.001), medication use for depression (p < 0.001), history of postpartum depression (p < 0.001), and medication use for other psychiatric conditions (p < 0.001) significantly increased during COVID-19 and remained at elevated levels post-COVID-19 compared with pre-COVID-19. Income >150% of the poverty level (p = 0.003), food security level (p = 0.010), marital status (p = 0.001), and private insurance type (p < 0.001) were significantly increased during COVID-19 compared with pre-COVID-19 levels. Future work should focus on stratifying the effects of the COVID-19 pandemic on maternal mental health by race and ethnicity and establishing guidelines to support maternal mental health during epidemics and pandemics.

63 Repeated Administration of Sucrose in Hospitalized Preterm Infants and Neurodevelopment at 18 Months

Abstract Background Preterm neonates, often hospitalized in the neonatal intensive care units (NICU), undergo multiple skin-breaking procedures. To minimize procedural pain, these infants frequently receive repeated administration of sucrose of varying concentrations and doses. Repetitive procedural pain has been associated with neurodevelopmental consequences, but long-term effects of repeated sucrose administration and volume are unknown. Objectives Our goal was to examine the association of total volume of sucrose over the NICU stay and neurodevelopment of preterm neonates at 18 months corrected gestational age (CGA). Design/Methods A prospective longitudinal observational study was conducted in four level-III Canadian NICUs. Infants &amp;lt;32 weeks of gestational age (GA) at birth and &amp;lt;10 days of life at enrollment were included. The minimally effective dose of 24% sucrose (0.1 ml) was administered prior to all skin-breaking procedures during the NICU stay. Total volume of sucrose administered for painful procedures was calculated for the full hospitalization. Infants were assessed at 18 months CGA by a trained observer using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The standardized mean score for each Bayley-III component was reported out of 100 (±15). Scores ≥85 are considered within normal limits. The association between sucrose and 18-month composite development scores, adjusting for birthweight and maternal use of medication for depression, were conducted using GEE models accounting for NICU site. Results Of the 168 infants enrolled in the study, 118 completed the Bayley-III assessment at 18 months (60% male, mean GA at birth 28.3 [±2.2] weeks, mean birth weight [1092 (±354) grams]). Infants received an average of 5.92 (±5.59) ml of sucrose during the hospitalization for an average of 58 (±70) skin-breaking painful procedures. The mean Bayley-III scores were within normal limits; cognitive 91 (±17), language 86 (±18), motor 88 (±17). There was no statistically significant association between total sucrose volume administered and cognitive (p=0.98), language (p=0.68), and motor (p=0.29) Bayley-III scores in the adjusted analyses. Conclusion Results do not generally indicate neurodevelopmental delay in preterm infants assessed at 18 months of CGA. The association between total sucrose volume administered for painful procedures and neurodevelopment requires more research as the infant matures, to better understand the impact of sucrose on long-term neurodevelopmental outcomes and with attention to potential confounders. The relationship between the combination of sucrose and other evidence-supported interventions (e.g., skin-to-skin care, breastfeeding) for all painful procedures during the NICU and neurodevelopment also requires further investigation.

Abstract 094: Sex-specific Effects Of Sleep Apnea And Medication-treated Depression On Left Ventricular Mass Index And 3D Left Ventricular Global Longitudinal Strain In The CARDIA Study

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. CVD risk increases with age; however, sex differences are known to significantly affect progression and survival. We designed this study to assess CVD-related risks associated with depression, sleep apnea, and depression comorbid with sleep apnea, in a biracial cohort of middle-aged men and women. We assessed outcomes such as left ventricular mass index (LVMI)-an index of left ventricular hypertrophy, and 3D left ventricular global longitudinal strain (3D LVGLS), an index of global myocardial function. Methods: Data were obtained from the Coronary Artery Risk Development in Young Adults (CARDIA) Study from black and white men and women (n=2778) who attended visit 9 (year 30 of follow-up) echocardiography scan. Demographics and diagnoses of depression and sleep apnea were obtained from visit 8 (year 25 of follow-up). Binary logistic regression was used to asses factors associated with high blood pressure (BP &gt; 130/80 mmHg) and heart failure with reduced ejection fraction (HFrEF). Linear regression analyses were used to assess the strength of the following predictors: race, age, depression diagnosis and medication use for depression on LVMI and 3D LVGLS. Results: In men, depression alone and comorbid with sleep apnea were associated with higher risk of BP &gt;130/80mmHg (OR = 1.47, p = 0.036 and OR = 2.739, p = 0.006, respectively). In both men and women (median age 55), black race was significantly associated with LVMI (p = 0.008 and p &lt;0.001, respectively). Additional predictors of LVMI found in women were age (p = 0.019) and current medication use for depression (p = 0.006). Black race and current use of medications for depression were significantly associated with 3D LVGLS in both men (p &lt;0.001 and p = 0.029, respectively) and women (p &lt; 0.001 and p = 0.007, respectively). Conclusion: Our results suggest that in middle-aged women, but not men, medication-treated depression is a significant predictor of LVMI. The sex differences were not observed for 3D LVGLS. These results suggest that the severity of depression (i.e. necessitating medication use) may be an important predictor of CVD, especially in women. However, a direct effect of these medications on CVD may occur.

Medication use for depression and anxiety: data collected from 28/29 year-old offspring in the Avon Longitudinal Study of Parents and Children

Patterns of mental health have been well characterised in the Avon Longitudinal Study of Parents and Children (ALSPAC), but there is a paucity of longitudinal medication data for depression and anxiety within the ALSPAC study. Understanding types and usage of pharmacological treatment allows for a deeper understanding of mental health in the ALSPAC study and key factors influencing illness outcomes, such as access to service provision. Enhanced understanding of the types of medication people have used to manage depression and anxiety could also give insight into which treatments work for individuals over the life course. This data note describes data collection on medication for depression and anxiety in the offspring (ALSPAC-G1) at ages 28-29 (born 1991/1992). Data were collected through a questionnaire deployed between December 2020 and April 2021. First, we highlight the variables collected as part of the questionnaire, specifically on medication use for depression and anxiety. We then outline how we have derived antidepressant variables including type of antidepressants, length of time used, and treatment phenotypes such as ‘remission’ and ‘non remission’. Finally, we also report associations between longitudinal mental health variables and reported use of medication and antidepressant variables to validate these new measures. Considerations for how the data collected can be used for researchers is also summarised.

Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults.

Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension. We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status. Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis. A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41-5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42-4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22-4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05-3.38; P = 0.040) anxiety symptoms were more likely to have hypertension. Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.

Ethnic Determinants of Health and Medication Use for Depression Among US Latinx Adults.

Medication use for depression among US Latinx adults is low (34%) and commonly associated with systems-related and individual-related cultural factors. Social determinants of health (SDH) include economic, environmental, educational, community, and healthcare systems factors. Ethnic determinants of health (EDH) are SDH factors specific to an ethnic group and described by an ethnic and disparities framework. To assess relationships between EDH factors and depression medication use among non-Latinx White (NLW) and Latinx adult populations using data from a weighted national sample for hypothesis building. Weighted responses to 2015-2018 National Survey on Drug Use and Health surveys from NLW, Latinx, and Latinx adult respondents from Puerto Rico, Mexico, and other Latinx countries were compared. Bivariate analyses were conducted using 2-way cross tabulation and a Wald chi-square test of association. EDH variables were characterized within the construct domains of systems-related geographic location, education, and economic stability, and individual-related cultural factors. Prescription medication use for depressive symptoms is 16.6% (P < 0.05) lower among a national sample of Latinx compared with NLW adults with major depressive episode (MDE). Many differences among systems-level EDH variables between Latinx and NLW populations with MDE were also found between populations with depression medication use. Of note, seeing a primary care provider or psychologist or social worker was significantly different among populations with MDE but not for those with depression medication use. Individual-related cultural EDH variables of overall health and serious psychological distress were significantly worse for Latinx than NLW populations with depression medication use. However, stigma, healing beliefs, and religious beliefs were not different between populations with MDE or depression medication use. Differences between certain Latinx populations with depression medication use were found with limited English proficiency and living in poverty. EDH variables for environment-physical characteristics or community and interpersonal levels of analysis were not represented within the NSDUH survey. Seeing a primary care provider or behavioral health specialist, depression severity, and overall health status appear to be important factors related to depression medication use among Latinx adults. Given the limitations of these analyses, multivariate analyses of EDH factors and other Latinx populations are warranted.

Later-life transitions and changes in prescription medication use for pain and depression

BackgroundOver the past two decades, prescription medication use for pain and depression increased dramatically. Most studies consider the early life course, despite a similar increase among those in later life. In this paper, we examine whether and how later life transitions may relate to changes in medication use.MethodsWe draw on data from the Health and Retirement Study and fixed-effects models to examine whether work, family, and civic transitions in later life are related to changes in the usage of prescription pain and depression medication.ResultsResults show that individuals had higher odds of regularly using prescription pain and depression medications in periods when out of the labor market. Higher odds of depression medication use were also associated with periods of widowhood, and lower odds of use when frequently volunteering. Such relations persist adjusting for reported levels of pain and depression.ConclusionOur findings call attention to the importance of social ties and the presence of actors that may regulate health behaviors, as well as a change in social context, that may shape medication use in later life.

Validity of self-reports of medication treatment of depression in general population surveys.

To assess the concurrent validity of a single question on medication use for depression in a general population survey. Using data from 2015 to 2016 and 2017 to 2018 National Health and Nutrition Examination Survey, we compared responses to a single question on medication use for depression with responses to a detailed questionnaire confirmed by inspecting medication packages or pharmacy printouts. There was a strong agreement (96.4%) between response to a single question about using medication for depression and responses to questions about using antidepressants or other psychiatric medications for depression on the detailed questionnaire. The single-question assessment had excellent sensitivity (93.8%) and specificity (96.7%), positive predictive value (71.5%), and kappa (0.79). Psychometric properties were mostly consistent across population subgroups. Single-question assessments of medication use for depression have acceptable concurrent validity against more detailed assessments and provide an efficient method for assessing medication treatment of depression in population health surveys.

Abstract 9027: Predictors of Willingness to Change Dietary Patterns in Patients With Atrial Fibrillation

Introduction: There has been a significant body of international literature supporting the favorable role of diet and lifestyle interventions in improving outcomes in patients with atrial fibrillation (AF). US-based dietary studies are limited. We aimed to study the predictors for patients willing to consider diet changes so target populations can receive increased attention in regards to dietary education. Methods: We conducted a pilot telephone survey to discuss willingness to participate in guided dietary intervention in patients with AF at a tertiary care center. If the patients were willing to participate, the process would entail diet counseling via bi-weekly phone calls and monthly surveys to assess dietary compliance. There was no financial incentive offered for their participation. Chart review was done to collect patient characteristics. Zip code was used as a surrogate to determine income level based on census data. Results: We attempted to contact 409 patients of whom we were able to reach 162 (39%) patients. 59 patients (36%) were willing to consider diet modification (Group A) while the remainder patients declined (Group B). The average age for both groups was similar (69±8 and 68±9 years respectively). There were 38% and 47% women in groups A and B respectively (p=0.4) There was no difference in the BMI, type of atrial fibrillation, EF, history of hypertension, diabetes, CAD, CKD, anxiety or depression medication use. Social determinants such as marital status, insurance status was similar in both groups. The median income was $57,500 in the study population. The ratio of patients with income over this level was identical in Groups A and B (46 and 52% respectively, p =0.5)There were significantly higher proportion of Caucasian patients in Group A compared to Group B (p=0.02). Patients in Group A were on a lower number of medications compared to Group B (7.3±4 vs 9±4 respectively, p =0.03). Conclusions: Patient willingness is generally the first factor for successful implementation of lifestyle modifications. Determining the factors which drive this willingness or pose as barriers to lifestyle modification can assist in formulation of targeted intervention strategies.

48. Depression severity and its impact on spine surgery outcomes

<h3>BACKGROUND CONTEXT</h3> Patients with chronic back pain have an estimated two to three times greater prevalence of depression than the general population. Approximately one-third of patients with chronic back pain who undergo surgery suffer from symptoms of depression. Several studies have demonstrated preoperative depression to be a positive predictor of lower quality of life, greater pain, and morbidity in patients undergoing spine surgery. Depression is a disease with a wide spectrum of symptoms and severity. To our knowledge, there is a lack of information regarding what severity of depression leads to poorer outcomes following spine surgery. <h3>PURPOSE</h3> The purpose of this study is to investigate the impact of depression severity on perioperative outcomes in spine surgery patients using prospectively collected PROMIS Depression Scores. <h3>STUDY DESIGN/SETTING</h3> Retrospective analysis. <h3>PATIENT SAMPLE</h3> All patients >18 years of age who underwent spine surgery between January 1, 2010 and January 31, 2019. <h3>OUTCOME MEASURES</h3> Measures examined include: PROMIS depression scores, PROMIS physical functional scores, PROMIS pain interference scores, opioid use, length of stay and complications. <h3>METHODS</h3> A single center, retrospective review of patients >18 years of age who underwent spine surgery was performed. Study subjects undergoing spine surgery between January 1, 2017 – January 31, 2019 were included. Spine surgery was defined as the ICD-9/10 codes for laminectomy, discectomy and spinal arthrodesis. To be included in the study, patients required completed pre and postoperative PROMIS depression scores, as well as minimum 1-year follow up. Patient charts were reviewed for demographic and surgical data, PROMIS physical functional scores, PROMIS pain interference scores, opioid use, length of stay and complications. Patients were then divided into 4 groups based on severity of depression, PROMIS depression T scores 0 – 49 (no depression, Group 1), 50 – 54 (mild depression, Group 2), 55- 64 (moderate depression, Group 3) and 65+ (severe depression, Group 4). <h3>RESULTS</h3> A total of 139 patients were included: 39 (28.1%) Group 1, 30 (21.6%) Group 2, 54 (38.8%) Group 3, and 16 (11.5%) Group 4. There were no differences in regards to age, sex, BMI, smoking, procedure and Frailty index scores (p>0.05). Differences existed between preoperative diagnosis of depression (p=0.004) and preoperative depression medication use (p=0.013). Preoperative opioid use was highest in Group 4 at 35.7%, compared to 27.9% (Group 3), 4.2% (Group 2) and 9.4% (Group 1). Preoperative physical functional scores were worst in Group 4 and statistically significant as compared to Group 1 (p=0.015). Preoperative pain interference scores were worst in Group 4 and statistically significant as compared to Group 1 (p =0.004). Postoperative function and postoperative pain at 6 months were worst in Group 4 (p=0.008). <h3>CONCLUSIONS</h3> Patients with the most severe depression have both the worst pre- and postoperative functional and pain scores when compared to mild and moderate depression. Preoperative depression PROMIS scores may be an accurate method to judge control of depression symptoms prior to operating and ultimately may help in improving outcomes in spine surgery patients. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Association of dual and poly tobacco use with depressive symptoms and use of antidepressants

BackgroundThere is an established link between depression and tobacco use among adults; however, to date, research has not explored the association of use of dual/poly tobacco products with symptoms and use of medication for depression. MethodsData were derived from a 2018 Texas population health assessment survey (n = 2034). Multivariable logistic and multinomial regressions were used to examine for associations between self-reported symptoms of depression and use of prescription medications for depression with use of dual/poly tobacco products. ResultsAbout 20% of adults used one tobacco product, while 9.7% used two or more products. Compared to those without depressive symptoms, those with depressive symptoms had greater odds of single (aOR: 1.66, 95% CI; 1.21 – 2.29) or dual/poly (aOR: 3.09, 95% CI; 1.92 – 4.96) tobacco product use relative to non-users; and relative to single product use, those with depressive symptoms had greater odds of dual/poly tobacco product use (aOR: 2.07; 95% CI, 1.30 – 3.32). Compared to those not using medication for depression, use of medication for depression was associated with a 1.80 (95% CI: 1.15 – 2.84) greater odds of dual/poly tobacco product use relative to non-users; and a 1.91 (95% CI: 1.14 – 3.19) greater odds of dual/poly product use relative to single product users. ConclusionsStudy findings call for primary care providers and psychiatrists to expand screening of individuals experiencing depressive symptoms and using medication for depression, to include assessment for dual/poly tobacco product use.

Association of Education and Depressive Symptoms with Tooth Loss

Previous evidence suggests the association of lower educational attainment and depressive symptoms with tooth loss. The hypothesis of this study was that these factors may exacerbate the effect on tooth loss beyond the sum of their individual effects. We aimed to clarify the independent and interactive effects of educational attainment and depressive symptoms on the number of missing teeth among community residents. Cross-sectional data of 9,647 individuals were collected from the general Japanese population. Dental examination was conducted by dentists. Educational attainment was categorized into 3 levels based on the number of educational years: ≤9, >9 to ≤12, and >12 y. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms; a total score of ≥16 and/or the use of medications for depression indicate the presence of depressive symptoms. In the multivariate analysis with adjustment for conventional risk factors, educational attainment was identified as a determinant of the number of missing teeth (>9 to ≤12 y of education: coefficient = 0.199, 95% confidence interval [CI], 0.135 to 0.263, P < 0.001; ≤9 y of education: coefficient = 0.318, 95% CI, 0.231 to 0.405, P < 0.001: reference, >12 y of education). An analysis that included interaction terms revealed that the relationship between “≤9 y of education” and the number of missing teeth differed depending on the depressive symptoms, indicating a positive interactive association (coefficient for interaction = 0.198; 95% CI, 0.033 to 0.364, P for interaction = 0.019: reference, >12 y of education). Our study suggests the presence of a significant association between educational attainment and tooth loss, as well as a partial interactive association between “≤9 y of education” and “depressive symptoms” in the general Japanese population.

Distress and mental health care and medication use among survivors of multiple primary cancer diagnoses: Findings from the 2016 National Health Interview Survey

ObjectiveOver 1 million survivors of multiple primary cancer (MPC) diagnoses reside in the USA. Information regarding their physical and mental health status is limited. This study examined distress and mental health care use among MPC survivors relative to survivors of a single primary cancer (SPC) diagnosis. MethodsUsing the 2016 National Health Information Survey, MPC survivors (n = 265), SPC survivors (n = 2103), and no cancer controls (NCC; n = 28,320) were identified. The MPC group was compared to the SPC and NCC groups with regard to multiple distress indices and use of mental health care and anxiety and depression medication. ResultsRelative to the SPC group, the MPC group reported more Total Distress (M = 9.59 vs. 8.84; p < .001), and were more likely to report daily or weekly anxiety feelings (OR = 2.07; p < .001), meet criteria for serious psychological distress (OR = 1.49; p = .02) and have talked to a mental health professional (OR = 1.75; p = .01). Comparison of MPC and NweCC groups yielded similar results. The MPC group did not differ from the SPC or NCC groups in severity of anxiety or depression feelings, distress interference, or anxiety and depression medication use. ConclusionsMPC survivors reported greater distress relative to SPC survivors. The clinical significance of this greater distress is unclear, however. While MPC survivors were more likely to have talked to a mental health professional, uptake of mental health care appeared to be suboptimal. MPC and SPC survivors might be considered distinct subgroups and increased attention devoted to potentially unique mental and physical health needs of MPC survivors.

Antenatal depression, psychotropic medication use, and inflammation among pregnant women.

To evaluate the association between psychotropic medication and inflammatory biomarkers in women with antenatal depressive symptoms (ADS). In this cross-sectional secondary analysis of a prospective multicenter observational study, 723 pregnant women underwent a depression screen using the Center for Epidemiologic Studies Depression Scale (CES-D) between 12 and 21weeks gestation. Self-reported use of medications for depression and/or anxiety was corroborated with the medical record to document exposure to pharmacotherapy. Serum was collected and inflammatory biomarkers (IFNγ, IL13, IL6, IL8, TNFα, CRP) were measured concomitantly. Women were included if they fell into one of three categories: ADS responsive to treatment (CES-D < 16 with medication), ADS not responsive to medication (CES-D ≥ 23 despite medication), and untreated ADS (CES-D ≥ 23 with no medication). Levels of inflammatory biomarkers were compared among groups and multivariable regressions performed. Of the 85 women studied, 16 (19%) had ADS responsive to treatment, 12 (14%) had ADS not responsive to medication, and 57 (67%) had untreated ADS. TNFα concentrations significantly differed (P = 0.016) across the cohorts. Post hoc bivariate analyses demonstrated that women with ADS responsive to treatment had lower serum TNFα than non-responders (p = 0.02) and women with untreated ADS (p = 0.01). There were no differences in IFNγ, IL13, IL6, IL8, or CRP among the groups. Regressions demonstrated that, compared to women with ADS responsive to treatment, non-responders or women with untreated ADS had higher TNFα levels (β = 0.27, 95% CI 0.02-0.52 and β = 0.23, 95% CI 0.02-0.44, respectively). Pregnant women on pharmacotherapy who respond to treatment for ADS have lower TNFα compared to women not responsive to medication or women with untreated ADS. These data suggest the possibility that either the therapeutic response in the context of pharmacotherapy is accompanied by modulation of the immune system or that pre-existing higher levels of TNFα may be associated with a poorer response to traditional pharmacotherapy.

Posttraumatic stress disorder after spinal cord injury.

The objective of the study was to identify the relationships of demographics, injury-related characteristics, employment, depressive symptoms, and health events with posttraumatic stress disorder (PTSD) among participants with spinal cord injury. A total of 1,063 participants were recruited from 3 sites in different regions (Southeastern, Mountain, and Western) of the United States. Hispanics and non-Hispanic Blacks were oversampled. Three hundred sixty-nine were non-Hispanic White, followed by 361 non-Hispanic Black, 277 Hispanic, and 56 from other racial-ethnic groups. PTSD was measured by the Purdue PTSD Scale-Revised. All variables were measured by self-report. Multivariate logistic regression models were developed to assess the association between PTSD and multiple variables. The overall prevalence of PTSD across all participants was 24.9%, and the mean PTSD score of all participants was 34.7 (SD = 14.6). PTSD was associated with depression, frequency of medication use for depression or stress, number of times receiving medical care because of injury in the past year, and race-ethnicity (lower among non-Hispanic Whites). PTSD was relatively prevalent in this study. PTSD was highly comorbid with depressive disorders and associated with post-spinal cord injuries within the previous year. (PsycINFO Database Record

Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States.

Purpose This study used population-based data to estimate the percentage of cancer survivors in the United States reporting current medication use for anxiety and depression and to characterize the survivors taking this type of medication. Rates of medication use in cancer survivors were compared with rates in the general population. Methods We analyzed data from the National Health Interview Survey, years 2010 to 2013, identifying cancer survivors (n = 3,184) and adults with no history of cancer (n = 44,997) who completed both the Sample Adult Core Questionnaire and the Adult Functioning and Disability Supplement. Results Compared with adults with no history of cancer, cancer survivors were significantly more likely to report taking medication for anxiety (16.8% v 8.6%, P < .001), depression (14.1% v 7.8%, P < .001), and one or both of these conditions combined (19.1% v 10.4%, P < .001), indicating that an estimated 2.5 million cancer survivors were taking medication for anxiety or depression in the United States at that time. Survivor characteristics associated with higher rates of medication use for anxiety included being younger than 65 years old, female, and non-Hispanic white, and having public insurance, a usual source of medical care, and multiple chronic health conditions. Survivor characteristics associated with medication use for depression were largely consistent with those for anxiety, with the exceptions that insurance status was not significant, whereas being widowed/divorced/separated was associated with more use. Conclusion Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.

Depression and Insomnia in Patients With Psoriasis and Psoriatic Arthritis Taking Tumor Necrosis Factor Antagonists.

Psoriasis patients with moderate to severe disease often present with depression and insomnia. Treatment targeting both psoriasis and psychological comorbidities is needed to improve the quality of life of these patients.In this nationwide cohort study, a total of 980 patients with psoriatic arthritis or psoriasis who had received nonbiological disease-modifying antirheumatic drugs and biologics therapy between 2009 and 2012 were identified. The prevalence rates of patients taking medications for depression and insomnia were compared before and after biologics therapy. Logistic regression method was used to investigate the risk factors for depression and insomnia. Further stratified analyses were performed to examine the prevalence of use of medications for depression and insomnia among different patient subgroups.The prevalence of patients taking regular antidepressants before starting biologics therapy was about 20%. There was a more than 40% reduction in this prevalence after biologics therapy for 2 years. Age higher than 45 years, female sex, presence of comorbidities, and psoriatic arthritis were independently associated with depression and insomnia. Further stratified analyses revealed a more rapid and significant reduction in depression/insomnia in those undergoing continuous biologics therapy, younger than 45 years, without psoriatic arthritis and not taking concomitant methotrexate, when compared with their counterparts.The results suggest that biologics therapy may be associated with reduced rates of depression and insomnia, and a reduced rate of regular antidepressants use in psoriasis patients.

Depression literacy of undergraduates in a non-western developing context: the case of Sri Lanka.

BackgroundResearch examining the depression literacy of undergraduates in non-western developing countries is limited. This study explores this among undergraduates in Sri Lanka.MethodsA total of 4671 undergraduates responded to a survey presenting a vignette of a depressed undergraduate. They were asked to identify the problem, describe their intended help-seeking actions if affected by it and rate the helpfulness of a range of help-providers and interventions for dealing with it. Mental health experts also rated these options, providing a benchmark for assessing the undergraduates’ responses.ResultsOnly 17.4 % of undergraduates recognised depression, but this was significantly lower among those responding in Sinhala compared to English (3.5 vs 36.8 %). More undergraduates indicated intentions of seeking informal help, such as from friends and parents, than from professionals, such as psychiatrists and counsellors. However, a majority rated all these help-providers as ‘helpful’, aligning with expert opinion. Other options recommended by experts and rated as ‘helpful’ by a large proportion of undergraduates included counselling/psychological therapy and self-help strategies such as doing enjoyable activities and meditation/yoga/relaxation exercises. However, a low proportion of undergraduates rated “western medicine to improve mood” as ‘helpful’, deviating from expert opinion. Although not endorsed by experts, undergraduates indicated intentions of using religious strategies, highly endorsing these as ‘helpful’. Labelling the problem as depression and using mental health-related labels were both associated with higher odds of endorsing professional help, with the label ‘depression’ associated with endorsing a wider range of professional options.ConclusionsThe recognition rate of depression might be associated with the language used to label it. These undergraduates’ knowledge about the use of medication for depression needs improvement. Health promotion interventions for depressed undergraduates must be designed in light of the prevalent socio-cultural backdrop, such as the undergraduates’ high endorsement of informal and culturally relevant help-seeking. Improving their ability to recognise the problem as being mental health-related might trigger their use of professional options of help.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1589-7) contains supplementary material, which is available to authorized users.

Social network of family caregivers of disabled and dependent patients.

Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p<0,05. Few caregivers participated in activities outside the home and the average number of people they had a bond was 4,4 relatives and 3,6 friends. Caregivers who reported pain and those who had a partner had higher average number of relatives who to trust. The average number of friends was higher in the group that reported use of medication for depression. Total and per capita incomes correlated with the social network. It was found that family members are the primary caregiver's social network.